After 4 yrs of being on KETO - My Empirical Study

After 4 yrs of being on KETO - My Empirical Study

It all started with the fascination of how eating fat can make one lose weight.

Going on The Keto Diet has definitely bought on new insights and perspectives to the properties and functions of fats, importance of macro composition and nutrient density.

For ages and ages, fats has been demonized. It has been name shamed, blamed and notoriously famed to the depths of hell and back. 

Thanks to KETO, fats has managed to clear its bad reputation, comeback in glory and reclaim its distinct standing on the nutritional pedestal.

Here are my observations based on a sampling size of about 50 participants (including myself)

Men on KETO <20g

Over 90% of the male participants managed to stay on the plan and continue the KETO diet for over 6 months quite easily with minimal disruptions and problems.

In general, we also noticed that most of the KETO advocators are men and there is a much higher rate of success for men

 Women on KETO <20g

Over 60% of the female participants found it relatively easy to stay on the plan for about 1-3 weeks. Some continue for about 3 months, & minority of them continue and move on the continue the KETO diet for over 6 months.

Most of the women that came off the plan reported strong food cravings, greater mood swings and irritability (especially on days nearer to the start of their menstrual cycle.)


In general, the older the participants, the easier it is for them to stay on KETO. Especially those for men over 35 and women over 40. For women, on the other hand, there is another factor to consider; before or after childbirth. Women after childbirth seems to have a better tolerance for this diet and experience less hormonal/craving issues than a woman who has not given birth before. 

Activity Level

Participants with high physical activity levels generally find it harder to stay on KETO <20g. They will experience stronger carb cravings and tend to required carb re-fuel or carb cycling.

Previous Diet & Food Preferences

In general, the KETO Diet is a great option for people who enjoy typically high fat junk foods like the standard burgers, deep fried snacks, meats, decadently rich desserts, ice creams and high dairy foods.     

If your previous diet is high in processed carbohydrates, sugars & fats, KETO is definitely a better option as it focuses on natural whole foods and omits sugar. 

Starting Weight & Body Fat Levels

Participants that started KETO with an Overweight BMI of 29 or higher are able/ have a higher tendency to stay on the KETO Diet for a longer period of time than those that started with a Healthy BMI level of 23 or lower.     

Carb Level for Ketosis

The carb level for ketosis is generally determined by type of food, health condition and activity level. This carb level can vary from 0g to 60g, depending on individual conditions. 

One common misconception is that the lower the carb, the more "KETO the food”.

NO, IT IS NOT. You also have to consider the nutrients, source, functions, and how your macros are balanced in general. To judge a food purely based on carb level is a simplistic view that adds to future complications.    

Type of Foods for Ketosis

There are KETO acceptable food lists all over the internet. These lists serves as a general guideline about the carb levels of the foods. If the food is higher in carbs, more attention to portion control is required.

We found out that food that are higher in carb levels but moderate/low in GI & GL can still bring on ketosis. PORTION SIZE + CLEAN & NATURAL + UNPROCESSED is key. 

There is no such thing as KETO food, but there are LOW CARB foods.

Amazing Benefits 

Blood Glucose Management

All the participants saw a significant improvement in their fasting blood glucose levels after 10 days. These include diabetics and pre-diabetic individuals. This benefit tends to stay as long as the individual does not revert to a high carb, high processed food diet but stay on a natural whole food diet with a moderate level of carbs. 

Pre-diabetics on KETO <20g had their blood glucose levels readjusted to a normal reading of of under 100mg/dl or 5.6mmol/l in 14 days. Maintenance at KETO <50g with good carbs and exercise. 

Diabetics (subjected to severity) on KETO <20g saw consistent improvement on their blood glucose levels. Cases of reversal start from 3 months onwards for mild diabetics and 9 months to 1 year onwards for more serious diabetics

Weight Loss

Amongst all the diets I know, the low carb KETO diet is one of the fastest and quickest way to achieve instant weight loss. It works especially fast on sugar burners, or individuals who is usually on a high carb diet.

The quick weight loss makes it extremely attractive (like a get rich quick scheme lol) since most of the population are predominately on a higher carb diet.

Men: Weight loss vary from 0.5kg per week to 3kg per week

Women: Weight loss vary from 0.2kg per week to 2kg per week 

Mental Clarity & Improved Energy Levels

Heightened mental alertness and better energy levels are reported by over 90% of the participants. Their mind feels clearer, brain fogginess is gone and they are able to focus and concentrate better. The lower carb meals helps to stabilise blood glucose and mental sluggishness caused by high glucose levels. 

However, there is a point where the mind switches from alertness to anger & irritability.

For those who are new to the diet, it could be an adaptation phase where the body & brain has to learn how to run on ketones instead of glucose.

For those who are fat adapted or have been on the diet for an extended period of time (for more than 6 months) this could be caused by the low glycogen storage, constant ketosis stress, or various hormonal imbalance. 

Sugar Addiction & Food Reliance

Over 80% of the participants recognised their reliance on sugar and managed to lower their cravings for sugar or high carb foods.

There are mainly 2 parts to an addiction; Habit and Physical Need. KETO bakes or sugar free foods helps to curb cravings in parts. Firstly, the physical need for sugar is controlled through the low carbs foods. The habit or taste for sugar is maintained through the KETO bakes. Once your body is used to running on a low carb low sugar diet, then it becomes easier for one to identify whether their need for sweet treats is physical, habitual or taste reliance.   

Well, there’s always more than 2 sides to everything - The Good, The Bad & The Ugly 

Side Effects of KETO 

Hair Loss on KETO <20g KETO

More than 80% of the participants experience unwanted hair loss on KETO <20g after 1 month. The solution from many Keto doctors or practitioners are to take biotin, collagen, increase protein intake, supplements etc.

But it seems to me that the hair loss is a result of hormonal imbalance and constant ketosis stress. And I’m not sure if solutions of such nature is really addressing the root cause of the issue. 

Some saw an improvement and also reported hair growth after sticking through the diet for an extended period of time. But seriously? Who can guarantee that the hair will grow back? And what about the period of distraught moments that one has to go through during the stage of hair loss? 

Digestion on KETO <20g KETO

Some of the participants experienced diarrhoea and runny stools, others became constipated. Only less than 5% of the participants reported no change.

It also seems to aggravate other gut issues like piles and haemorrhoids conditions. The insufficient fiber of a <20g does not fare well in the gut health department.  

Stool quality also tend to be soft and sludgy. 

Eating Disorder on KETO <20g KETO

It is something that is unspoken of, but it is something real that is happening. The deliberate abstinence and avoidance of carbs does stir up eating disorder amongst many; mostly women, but men included too. These include binge eating, bulimia and anorexia. Unfortunately, this leads to a whole long line of unspoken and unknown complications like hormonal imbalance, thyroid dysfunction, slow metabolism and also not forgetting, most importantly, emotional damage.    

Weight Rebound on KETO

Participants who did not wean off KETO in the correct manner tend to experience a major weight rebound. Those who went back immediately to a unhealthy processed food junk diet saw a quick regain of weight or even more.

After an extended period of <20g KETO, the body seems to lose or ‘forget” its ability to burn sugar and use it as a fuel.

Some say it is insulin sensitivity, I wonder if it is insulin oversensitivity.

Also other report discomfort when consuming higher carb foods and thus condemning carbs. Isn’t this the same as the KETO flu one experiences when they are not used to burning fats as a primary source of fuel?   

Other Personal Observations 

About me: I am Asian Chinese Singaporean early 40s woman with 1 child. My medical struggles include hormonal imbalances, PCOS, endometriosis, multiple fibroids & cysts which I subsequently managed to rid without surgery but through healing diets. (Gone through too many surgeries resulting in abdominal adhesions because of conventional western medicine advice *eye roll)

My experiences has led me to consider multiple doctrines including Western Medicine, Traditional Chinese Medicine and Ayurvedic Medicine before I qualify a piece of information or health advice.

I am/was also a fighter of depression, anorexia & bulimia.

Endurance Levels

While many active individuals report lower performance on their athletic and endurance levels, I personally experience improved endurance levels through my workout. My body seems to be able to make a switch from sugar burning to fat burning and ketone running rather easily. I on the other feel more energy as halfway and towards the end of my exercise regime.

(I used to struggle to complete a 90mins 41C Bikram on a high carb diet, but I can complete 2 back to back 90mins Bikram classes on a KETO diet)

Stress Levels

The process of ketosis in itself is a stress for the body. Coupled with external additional stress, it is a sort of double whammy. On days where stress levels are much higher than usual, staying on <20g KETO is not only a mental challenge but also added stress to the adrenals. 

In & Out of Ketosis

Unless for other medical reasons, the optimal zone for ketosis is between 1-3. I find it easier to continue KETO in a slow and steady manner. Get into ketosis zone of 1-3, stay for a day or so, then get out of ketosis with natural whole foods. It also helps me to build metabolic flexibility and train my body to run on sugar & fat without forgoing the ability to tap on the other energy source.

Running on Ketones

I love the mental clarity and brain functions while running on ketones. Hunger and cravings are also much better managed during this time. However, my body and mind seem to burn out after staying in the zone for too long. I also do not enjoy the amplified side effects from staying in this state for an extended period of time. 

Supplements on KETO

If a diet requires one to take several supplements, I think that it will be quite fair to say that the diet is not balanced. Unless targeting a specific condition, I think a long term unbalanced diet will create future complication and imbalances of other kind.

Women on KETO

I found that women that constantly push for <20g KETO tend to experience hair loss, menstrual cycle loss, hormonal balances and eating disorders. This applies to women of all races, age, activity levels. Women over 50 also fare better or is able to sustain <20g KETO for a longer period of time with less side effects.

My proposal of 3 options:

  1. Average Daily Macros: About 1300 calories, 20g-50g Net Carbs, 50-80g of fats, 50-70g of protein with IF fasting & gut health foods
  2. Eat according to cycle: About 20g net carbs for Day 1 -18 of your menstrual cycle, practise varied fasting, and increase your carb levels nearer your cycle. Up to a 100g net carbs depending on your age & activity levels.
  3. Carb Cycling: 2 Days of higher good carbs with exercise & activity. 5 days of KETO <30g with IF & gut health foods

The initial weight loss might be slower than <20g KETO but you will experience less side effects and improve sustainability. Slow & Steady for the win.   

Starting KETO

Depending on your previous diet, I think it is better to start KETO slowly. If you are coming from high carb diet, it is better to start with lowering your carb levels first and omit Intermittent Fasting. Start with KETO <50g with eating natural whole foods and eliminating obvious carbs & sugars, processed foods & carbohydrates from your diet. Allow your body time to adjust to the new macro compositions. 

Do not rush into intense exercise for fasted exercise for safety reasons.  

Practising Sustainable KETO

I would say KETO in & KETO out. Have low carb or KETO days on days with lower activity and other days with higher carb levels on active days -  Carb cycling for metabolic flexibility 

Unless severely overweight, diabetic or other specific medical conditions, I don't think a long term <20g KETO diet is advisable for the general healthy individual. 2-4 weeks <20g KETO diet for weight/health adjustments or a longer term 50g KETO for maintenance seems to be more ideal. 

Coming Off KETO 

To avoid severe weight rebound, slowly increase your carb levels to allow your body to adjust back to burning sugar efficiently again. Just as your body needs to learn how to be fat adapted, it also needs to learn how to burn sugar again.

Consume natural whole foods and moderate your fat contents in the food. Different macro compositions serve different purposes and functions. 

In general, I think the overall carb levels of the average diet should be lowered. The current average carb level of standard diet is 200g, I think that 50-100g is a much better range.

Additional 25g is reasonable for every 90mins of moderate exercise for a healthy individual 

This article is based on my 4 years of studying, observing and KETO practise. I hope it will provide a bit more insight into the KETO community or to people who are considering about giving KETO a try.  

A big thank you to each and everyone of you who shared your KETO journey, health condition and life experience with me so that I can gain this understanding and insights.  

P.S. I still do KETO, from time to time - Cyclical KETO mostly. I love and advocate the concept of Low Carb Healthy Fats. I think it is great health tool or therapy for blood glucose management, metabolic conditioning and other health condition adjustments. Everyone should try it for some time at some point in relevance to their health. 

"Every food serves a purpose, every diet work differently for everyone"



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